Drug access

Prescription drugs play an essential role in cancer treatment. Cancer drugs such as chemotherapy, hormone therapy, biological therapy and immunotherapy work in different ways to destroy cancer cells, stop them from spreading or slow down their growth. Drugs are also being used to lessen, or relieve, side effects of cancer or its treatment. Advances in cancer treatment, diagnostics and care have led to the net survival for people diagnosed with cancer to significantly increase. Today, over 60% of Canadians diagnosed with cancer will survive at least 5 years after their diagnosis. In the 1940s, survival was about 25%.

The healthcare system continues to evolve and adapt to meet the needs of patients, although there remain significant gaps in care. With regards to drug access, Canadians with cancer may face some of the following challenges:

• The best therapeutic option recommended by the oncologist is not listed on the formulary of the province of residence or by their private insurer.

• The best therapeutic option recommended by the oncologist is a take-home medication and the person resides in a province where there is no specific program in place to cover the cost of these medications. The person with cancer has to figure out how to access these drugs. Even with private insurance, some patients in this situation will end up having to pay thousands of dollars.

• The best therapeutic option recommended by the oncologist is in the process of being reviewed by one of the bodies involved in the drug approval process.

Dealing with a cancer diagnosis is difficult enough. People with cancer should not have to face additional challenges and anxiety trying to access their prescribed treatment.

For many years, cancer drugs were usually given in a hospital, and patients did not have to worry about how to access their prescribed treatment. Now, many new cancer treatments are taken at home instead of in the hospital. This has many benefits for a person who has cancer – the medicines are easy to take and less travel is required. But depending on the province, it also means the person with cancer has to figure out how to access these drugs.

In Ontario, for example, it may be necessary to go through as many as 6 programs to access coverage for prescribed take-home cancer drugs. The western provinces (British Columbia, Alberta, Saskatchewan and Manitoba) have programs for eligible cancer drugs given in a hospital or at home.

This disparity among provinces is not acceptable and must be fixed. Provincial and territorial governments should take immediate action to implement programs for take-home cancer drugs.

Drug shortages continue to occur in Canada and around the world and they will not be resolved without a Canada-wide approach. We know that shortages are deeply worrying to patients and their families – it’s simply not acceptable to go without the medication you need.

Over the years, the federal government has taken numerous actions to address the issue. As of March 2017, pharmaceuticals companies must now report on the website www.drugshortagescanada.ca:

• an anticipated drug shortage;

• a discontinuation of a drug six months in advance; and

• any previously unreported shortage within five days of learning about it.

This is a significant step forward and the Canadian Cancer Society will continue to actively engage with governments to ensure drug shortages are limited as much as possible. Patients must have access to an uninterrupted supply of required medication in a timely manner, without financial hardship.